Expansion of the program is optional for states.

Lawmakers give initial OK to Medi-Cal expansion to million more Californians

SACRAMENTO (AP) — State lawmakers gave initial approval Thursday to a pair of bills that would expand Medicaid to more than 1 million low-income Californians, a critical step to implementing federal health care reforms.

On mostly party-line votes, Democrats in the Senate and Assembly passed similar measures to expand the federal-state health program for the poor. The bills will switch houses while lawmakers work with Democratic Gov. Jerry Brown, who wants to minimize state costs.

Called Medi-Cal in California, expansion would take advantage of generous funding from the Obama administration to add those who make up to 138 percent of the federal poverty level, or about $15,400 for an individual. The nonpartisan Legislative Analyst's Office estimated the expansion will bring an additional 1.2 million new enrollees by 2017.

The program already serves about 8 million adults and children, nearly one of every five California residents.

"These are the patients with the absolute greatest need," said Sen. Ed Hernandez, D-West Covina, one of the bill's author. "We also have another opportunity to not only make sure that this vulnerable population continues to get these services, but we can expand it."

Most Republicans opposed the bills by Hernandez and Assembly Speaker John Perez, D-Los Angeles. They fear an expansion will increase state costs once federal funding is reduced.

The federal government will pay the full cost of expanding the low-income health program for the first three years and then gradually reduce payments to 90 percent starting in 2020, putting the rest of the cost on the state. Legislative analyst Mac Taylor has estimated that by taking on new enrollees, the state could be responsible for between $300 million and $1.3 billion a year starting in 2020.

Republicans say that even the 90 percent federal share could be reduced in the future if a new administration decides not to provide the funding.

SBx1-1 passed 24-7 in the Senate without any Republican support while ABx1-1 passed 53-22 in the Assembly. One Republican, Assemblyman Katcho Achadjian of San Luis Obispo, voted for the expansion.

The legislative analyst's report said the benefits of expanding health care for California's poor under the Affordable Care Act outweigh the costs to the state because the additional money can be used improve health care.

Sen. Jim Nielsen, R-Gerber, objected that the final details of the bill are still being negotiated. He also said the bill takes California beyond what the federal law requires.

Democrats pointed to the federal government's record of maintaining its level of matching funds for the current Medi-Cal program. If officials in Washington later reduce the amount of funding provided, the state in turn can adjust its program, supporters said.

"Do we leave a bill on the table and walk away from the opportunity to insure a million Californians out of fear about what may happen down the line?" said Assemblywoman Holly Mitchell, D-Los Angeles. "I suggest we don't."